EX-99.45 39 ex1423623-45.txt MELLON INVESTOR SERVICES STOCK POWER FORM FOR VALUE RECEIVED, I/WE HEREBY SELL, ASSIGN AND TRANSFER TO (1): _____________________________________________ SOCIAL SECURITY # OR TAX I.D. # OF NEW OWNER. (2)_____________________________________________________________________________ PRINT/TYPE ALL NAMES & ADDRESS OF NEW OWNERS, INDICATE IF JOINT, TRUST OR CUSTODIAN ACCOUNT _____________________________________________________________________________ _____________________________________________________________________________ City State Zip Code TRANSFER (3) _______________________ CERTIFICATE SHARES REPRESENTED BY THE ENCLOSED CERTIFICATE NUMBER(S) (4) _____________________________, AND/OR (5)__________________ BOOK-ENTRY SHARES (INCLUDING SHARES HELD FOR YOU IN A DIVIDEND REINVESTMENT OR OTHER PLAN). REGISTERED TO (6) ______________________________________________________________ ACCOUNT NUMBER (7) _____________________________________________________________ THE UNDERSIGNED DOES (DO) HEREBY IRREVOCABLY CONSTITUTE AND APPOINT MELLON INVESTOR SERVICES ATTORNEY TO TRANSFER THE SAID STOCK ON THE BOOKS OF _______________________________ WITH FULL POWER OF SUBSTITUTION IN THE PREMISES. Company Name SIGNATURE(S) OF REGISTERED OWNERS: Please sign as name appears on registration. Joint owners should each sign. When signing as attorney, executor, administrator, trustee or guardian, please give full title of such. (8)__________________________________ Date:________________________________ Signature of registered holder or authorized representative: __________________________________ Telephone:___________________________ Signature of Joint Owner Daytime number AFFIX MEDALLION SIGNATURE GUARANTEE by a financial institution enrolled in an approved Medallion Program pursuant to S.E.C. Rule 17Ad-15. --------------------------------------- | | | | | | | | | | | | | | --------------------------------------- PDX/112816/141153/DLH/1423623.1